Video games and stroke

Recovery from stroke is a major effort of Atlanta Hyperbaric.  Hyperbaric oxygen resupplies blood flow to the stroke penumbra, which leads to direct recovery of functional brain tissue, among other things.  Rehabilitation from stroke generally depends upon brain plasticity, or the ability of the brain to remodel brain cell connections in order to compensate for tissue death.  This brain remodeling activity occurs  through repetitive experience.  Exploring video games as a way to engage a stroke patient in an entertaining but repetitive fashion seems like a potentially helpful approach.

Researchers at the University of Toronto presented a study last month at the ASA stroke conference of use of the Nintendo Wii for stroke rehabilitation.   Twenty-two patients with recent mild-to-moderate stroke enrolled in the study.  The age of the patients averaged 61. All had some weakness in at least one of their arms, but were able to touch their chin and knee.  After playing for two weeks, the participants were able to shave off time from certain daily activities compared to controls who did not play the Wii.

In addition to conventional rehabilitation, half performed recreational therapy — playing cards and Jenga — and half played two Wii games, tennis and Cooking Mama.  Cooking Mama uses movements that simulate cutting a potato, peeling an onion, slicing meat, and shredding cheese — for eight one-hour sessions over two weeks.  A similarly high number of patients in each group completed all eight sessions — 90% with Wii and 80% with recreational therapy.

Only the patients in the Wii group significantly improved their fine motor function, measured using the Wolf Motor Function Test, which times patients while they perform daily activities, like grabbing a can of soda or folding a towel.  After adjustment for age, baseline functional status, and stroke severity, participants in the Wii group did significantly better on the test than the controls by 7.4 seconds.  Improvements of 2 seconds are believed to be clinically relevant.

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